2/15: Federal Xchange open for a special enrollment period-in most states you have until May 15 to try and get health care-many will qualify for subsidies including millions being able to have fully subsidized health insurance. Important first step but more needs to be done (1/n)
Paul Starr describes what we are in as a policy trap-referring to the "creation of a costly, inefficient system of health insurance that satisfies enough individuals and powerful stakeholders to neutralize an effective constituency for change" h/t Dr. Mical Raz (2/n)
Employer sponsored insurance is the trap with costs disguised as premiums subsidized by taxpayers and lost wages. Yet we (incl me) are tethered to this and it is seen as a reward for hard work also furthering the notion of individual responsibility (3/n)
So why does this matter?Covid has resulted in tremendous job losses, with lagging employer sponsored insurance losses, likely due to the time lag with COBRA as well as the growing no of employers who didn't offer health insurance. (4/n)
The special enrollment period was necessary but not sufficient. Read this incredible paper in @JAMA_current where Dr. Raz describes a likely political nonstarter but hey lets dream big- expand medicaid to all newly uninsured or unemployed people. jamanetwork.com/channels/healt… (5/n)
This approach would be more cost effective than subsidizing COBRA premiums but this will no doubt be a nonstarter with GOP and most insurance plans. But hey go big or go home as they say and well, I dont know about you but I am tired of being home. (fin)
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Thread on Variants- building on excellent work cited by @DrEricDing@CarlosdelRio7@BhadeliaMD but I am trying to distill it for mere mortals (me+my mom) (1/n)
B117 (2/n) 2. People infected have higher viral loads (likely making it more transmissible) academic.oup.com/jid/advance-ar… 3. has mutated in a bad way-evidence of the E484K mutation which is in the SA and Brazil variants-possibly making it even more problematic: sciencemediacentre.org/expert-reactio…
B117 (3/n) 4. 73 people introduced variant into the US and NY was a hub (no surprise) but again this is an undercount most likely: medrxiv.org/content/10.110… 5. here is a pattern of the travel from UK showing likely hubs of spread:
Agree that COBRA subsidies will likely not survive the Byrd rule along with a number of other provisions like vaccine funding/discretionary spending; get familiar with Senate Parliamentarian Elizabeth MacDonough, first female in that job, named to the office by Sen Reid (1/n)
The Senate Parliamentarian imho is one of THE most powerful positions in the Congress-past Parliamentarians have been fired bc their rulings have rubbed 1 party or the other the wrong way-something we might see if her ruling does not sit well with Dems. (2/n)
What this will force depending on her assessment of whether provisions are extraneous (and honestly my rule of thumb for Byrd is whether the provisions seem discretionary vs mandatory or are considered outside of nl appropriations cite territory)is for Sanders/others (3/n)
Thread of how we got to the point where the President is accusing FDA of being part of the Deep State. And why its shameful that neither the Secretary of HHS/FDA Commissioner/Director of the NIH have not vocally and frequently defended their agencies. (1/4)
(2/4):Hydroxychloroquine:3/30-EUA for HCQ issued with questions raised by sr staff about political pressure to approve drug prematurely. 4/8-POTUS said "what do you have to lose?" followed by warnings by MDs about deadly cardiac effects. 6/15: EUA revoked 7/28-Trump defends HCQ
(3/4) 2 days ago: FDA v HHS on LDT (lab developed tests)-great thread by @ASlavitt on this, but HHS pulled FDA's authority to review LDT. Making this more confusing was 2/3/20 CDC test EUA which had significant issues along w sense that FDA approved poor performing COVID tests
(1/5)Breakdown of some dynamics resulting in today's headlines around single day record of COVID cases (over 36k since 4/25. Drivers are multifactorial, but there are a few themes which are making this more difficult than we thought.
(2/5)1. Stay at home orders generally work, particularly when reinforced at national level; Curves were flattened and pressure to reopen too early won/no masks/inadequate testing/tracing/isolation support leading to community spread
(3/5) Additionally, data supports a higher number of young adults (as high as 60% of new cases in some regions)accounting for the numbers. But being young does not mean you are invincible; in TX/FL some hospitals reporting up to half hospitalized for COVID <50